Ankle Sprains Clinical Trial
Official title:
Addressing Neuromuscular Deficits for Improved Outcomes in Ankle Rehabilitation
The purpose of this project is to compare a novel sensorimotor ankle rehabilitation training (SMART) protocol for Lateral ankle sprains (LASs) against a standard of care (SOC) protocol to determine if it is more successful at producing successful one-year outcomes and lower rates of re-injury and improved health. This will address the identified needs for evidence-support and reintegration strategies to improve understanding of the management of patient rehabilitation strategies throughout the rehabilitation process following neuromusculoskeletal injury. The project will validate an innovative rehabilitation approach while providing metrics of success using a variety of clinical and innovative markers.
Status | Recruiting |
Enrollment | 150 |
Est. completion date | December 2025 |
Est. primary completion date | December 2025 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 44 Years |
Eligibility | Inclusion Criteria: - initiating rehabilitation for a first time acute grade I, II, or III LAS - have sustained within 72 hours of study enrollment - diagnosed by a physician, medic, athletic trainer, physical therapist, or other providing medical coverage in operational environments as having sustained a LAS Exclusion Criteria: - personal or familial history of epilepsy or seizures - history of migraine headaches - ocular foreign body, increased intracranial pressure, open head injury or significant closed head injury - cochlear implants - implanted brain stimulators, aneurysm clips or other metal in the head (except mouth) - implanted medication pumps, pacemakers or intracardiac lines - current medication with tricyclic anti-depressants, neuroleptic agents or other drugs that lower seizure threshold - history of diagnosed major psychiatric disorder - history of illicit drug use - current alcohol abuse or currently withdrawing from alcohol abuse - history of heart disease |
Country | Name | City | State |
---|---|---|---|
United States | University of North Carolina at Chapel Hill | Chapel Hill | North Carolina |
United States | University of Kentucky | Lexington | Kentucky |
Lead Sponsor | Collaborator |
---|---|
Phillip Gribble | United States Department of Defense |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Ankle re-injury rate | The number of patient reported re-sprains of the ankle. The outcomes will be assessed at 12 months post-rehabilitation discharge (ie. return to activity). | 12 months | |
Primary | Change in mental quality of life | Data are presented as the sum total from 8 questions. Group means and standard deviations will be reported. The outcomes will be assessed at the rehabilitation discharge visit and 6 and 12 months post-discharge and reported as change scores over time. | rehabilitation discharge visit, 6 and 12 months post-discharge | |
Primary | Change in physical quality of life | Data are presented as the sum total from 8 questions . Group means and standard deviations will be reported. The outcomes will be assessed at the rehabilitation discharge visit and 6 and 12 months post-discharge and reported as change scores over time. | rehabilitation discharge visit, 6 and 12 months post-discharge | |
Primary | Change in physical activity | Data are presented as a score from 0-10, with 10 being the highest level of self-reported physical activity. Group means and standard deviations will be reported. The outcomes will be assessed at the rehabilitation discharge visit and 6 and 12 months post-discharge and reported as change scores over time. | rehabilitation discharge visit, 6 and 12 months post-discharge | |
Primary | Change in self-reported Functional Ankle Instability | Data are presented as a score from 0-37 on the Identification of Functional Ankle Instability (IdFAI), with 0 indicating no self-reported ankle instability. Group means and standard deviations will be reported. The outcomes will be assessed at the rehabilitation discharge visit and 6 and 12 months post-discharge and reported as change scores over time. | rehabilitation discharge visit, 6 and 12 months post-discharge | |
Primary | Change in self-reported Ankle Instability | Data are presented as a score from 0-5 on the Ankle Instability Instrument (AII), with 0 indicating no self-reported ankle instability. Group means and standard deviations will be reported. The outcomes will be assessed at the rehabilitation discharge visit and 6 and 12 months post-discharge and reported as change scores over time. | rehabilitation discharge visit, 6 and 12 months post-discharge | |
Primary | Change in self-reported Ankle Disability | Data are presented as a percentage score from 0-100% on the Foot and Ankle Ability Measure (FAAM), with 100% indicating no self-reported ankle disability. Group means and standard deviations will be reported. The outcomes will be assessed at the rehabilitation discharge visit and 6 and 12 months post-discharge and reported as change scores over time. | rehabilitation discharge visit, 6 and 12 months post-discharge | |
Primary | Change in dynamic balance | Data are reported as linear reach distance normalized to leg length, which are presented as a percentage score, with higher percentage scores representing better dynamic balance. Group means and standard deviations will be reported. The outcomes will be assessed at the rehabilitation discharge visit and 6 and 12 months post-discharge and reported as change scores over time. | rehabilitation discharge visit, 6 and 12 months post-discharge | |
Primary | Change in ankle dorsiflexion Range of Motion | Data are presented as a linear distance with larger values representing more estimated joint range of motion. Group means and standard deviations will be reported. The outcomes will be assessed at the rehabilitation discharge visit and 6 and 12 months post-discharge and reported as change scores over time. | rehabilitation discharge visit, 6 and 12 months post-discharge | |
Primary | Change in corticomotor Excitability - Active Motor Threshold | Data are presented in millivolts with a higher number representing a lower level of cortical excitability. Group means and standard deviations will be reported. The outcomes will be assessed at the rehabilitation discharge visit and 6 and 12 months post-discharge and reported as change scores over time. | rehabilitation discharge visit, 6 and 12 months post-discharge | |
Primary | Change in corticomotor Excitability - Cortical Silent Period | Data are presented as a time value in milliseconds with a higher number representing a lower level of cortical excitability. Group means and standard deviations will be reported. The outcomes will be assessed at the rehabilitation discharge visit and 6 and 12 months post-discharge and reported as change scores over time. | rehabilitation discharge visit, 6 and 12 months post-discharge | |
Primary | Change in Spinal Excitability | Data are presented as a ratio with a smaller ratio representing a lower level of spinal excitability. Group means and standard deviations will be reported. The outcomes will be assessed at the rehabilitation discharge visit and 6 and 12 months post-discharge and reported as change scores over time. | rehabilitation discharge visit, 6 and 12 months post-discharge | |
Primary | Change in White Mater Structural Integrity | Data are presented as a scalar value ranging from 0-1.0 with lower values representing a greater loss of white mater structural integrity. Group means and standard deviations will be reported. TThe outcomes will be assessed at the rehabilitation discharge visit and 6 and 12 months post-discharge and reported as change scores over time. | rehabilitation discharge visit, 6 and 12 months post-discharge | |
Primary | Change in Ankle cartilage relaxation | T1rho -magnetic resonance imaging of the superior aspect of the talus in the ankle will be performed. Participant images will be assessed by a blinded observer and scored as a the amount of time required to achieve relaxation. The data are presented in milliseconds. The outcomes will be assessed at the rehabilitation discharge visit and 6 and 12 months post-discharge and reported as change scores over time. | rehabilitation discharge visit, 6 and 12 months post-discharge | |
Primary | Change in Ankle Articular Cartilage Turnover | Data are presented as a time value in seconds with longer values representing a greater amount of articular cartilage turnover. Group means and standard deviations will be reported. The outcomes will be assessed at the rehabilitation discharge visit and 6 and 12 months post-discharge and reported as change scores over time. | rehabilitation discharge visit, 6 and 12 months post-discharge |
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